New Health Care Law

There have been a number of different health care reforms proposed during the Obama administration. The first of these reform proposals to be passed by the United States Congress is the Patient Protection and Affordable Care Act, which originated in the Senate and was later passed by the House of Representatives in amended form on March 21, 2010 (with a vote of 219–212).President Obama signed the reforms into law on March 23, 2010

A clear goal of the new health care reform law is increased access to home-based care.

Last month’s health care law contained some benefits for the nation’s older population. It provided long-term care options to allow more seniors to stay in their current homes rather than seek institutionalized care, and called for more publicly available information about nursing homes.

The number of Americans over 65 will mushroom in the coming decade, as roughly 75 million Baby Boomers reach retirement age. Their long-term health care needs will strain the nation’s collective wallet, stretching thin programs like Medicaid and Medicare.

Meanwhile, more than 10 million Americans are currently in need of long-term services that help them function in their daily life, and that number is expected to rise to nearly 15 million by 2020, according to the National Council on Aging.

A variety of specific types of reform have been suggested to improve the United States health care system. These range from increased use of health care technology through changing the anti-trust rules governing health insurance companies and tort-reform to rationing of care. Different overall strategies have been suggested as well.

Reforming or restructuring the private health insurance market is often suggested as a means for achieving health care reform in the U.S. Insurance market reform has the potential to increase the number of Americans with insurance, but is unlikely to significantly reduce the rate of growth in health care spending. Careful consideration of basic insurance principles is important when considering insurance market reform, in order to avoid unanticipated consequences and ensure the long-term viability of the reformed system. According to one study conducted by the Urban Institute, if not implemented on a systematic basis with appropriate safeguards, market reform has the potential to cause more problems than it solves.

Critics have argued that medical malpractice costs (insurance and lawsuits, for example) are significant and should be addressed via tort reform.

How much these costs are is a matter of debate. Some have argued that malpractice lawsuits are a major driver of medical costs. A 2005 study estimated the cost around 0.2%, and in 2009 insurer WellPoint Inc. said “liability wasn’t driving premiums.” A 2006 study found neurologists in the United States ordered more tests in theoretical clinical situations posed than their German counterparts; U.S. clinicians are more likely to fear litigation which may be due to the teaching of defensive strategies which are reported more often in U.S. teaching programs. Counting both direct and indirect costs, other studies estimate the total cost of malpractice “is linked to” between 5% and 10% of total U.S. medical costs.

President Barack Obama argues that U.S. healthcare is rationed, based on income, type of employment, and pre-existing medical conditions, with nearly 46 million uninsured. He argues that millions of Americans are denied coverage or face higher premiums as a result of pre-existing medical conditions.

The payment system refers to the billing and payment for medical services, which is distinct from the delivery system through which the services are provided. The over 1,300 U.S. health insurance companies have different forms and processes for billing and reimbursement, requiring enormous costs on the part of service providers (mainly doctors and hospitals) to process payments. For example, the Cleveland Clinic, considered a low-cost, best-practices hospital system, has 1,400 billing clerks to support 2,000 doctors. Further, the insurance companies have their own overhead functions and profit margins, much of which could be eliminated with a single payer system. Economist Paul Krugman estimated in 2005 that converting from the current private insurance system to a single-payer system would enable $200 billion per year in cost savings, primarily via insurance company overhead. One advocacy group estimated savings as high as $400 billion annually for 2009 and beyond.